Indrė Vasiliauskaitė1, Silke Oellerich1, Lisanne Ham2, Isabel Dapena3, Lamis Baydoun4, Korine van Dijk3, Gerrit R J Melles5. 1. Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands. 2. Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands; Melles Cornea Clinic Rotterdam, The Netherlands;; Amnitrans Eye Bank Rotterdam, The Netherlands. 3. Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands; Melles Cornea Clinic Rotterdam, The Netherlands. 4. Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands; University Hospital Münster, Germany. 5. Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands; Melles Cornea Clinic Rotterdam, The Netherlands;; Amnitrans Eye Bank Rotterdam, The Netherlands;; NIIOS-USA, San Diego, USA;. Electronic address: research@niios.com.
Abstract
PURPOSE: To evaluate the 10-year graft survival and clinical outcomes of the first case series after Descemet membrane endothelial keratoplasty (DMEK). DESIGN: Retrospective, interventional case series. METHODS: After excluding the very first 25 DMEK eyes that constitute the technique learning curve, the following 100 consecutive primary DMEK eyes (88 patients) were included. Main outcome parameters (survival, best-corrected visual acuity (BCVA), central endothelial cell density (ECD), central corneal thickness (CCT)) were evaluated up to 10-years postoperatively and postoperative complications were documented. RESULTS: At 5 and 10 years after DMEK, respectively 68 and 57 out of 100 eyes were still available for analysis. Of those eyes, 82% and 89% reached a BCVA of ≥20/25 (Decimal VA ≥0.8) at 5- and 10 years postoperatively, respectively. Preoperative donor ECD decreased by 59% at 5 years and 68% at 10 years postoperatively. CCT averaged 668 (±74) μm preoperatively, and 540 (±33) μm and 553 (±43) μm at respectively 5 and 10 years after surgery. Within 10 years, 4% of eyes developed allograft rejection, no primary graft failures occurred and 6% of the eyes developed secondary graft failure. Graft survival probability was 0.83 [95% Confidence Interval (CI), 0.75-0.92] and 0.79 [95% CI, 0.70 -0.88] at 5- and 10-years postoperatively, respectively. CONCLUSION: Most eyes operated in the pioneering phase of DMEK show excellent and stable clinical outcomes with low postoperative complication rates and promising graft longevity over the first decade after surgery. This suggests that DMEK may be a safe long-term treatment option for corneal endothelial diseases.
PURPOSE: To evaluate the 10-year graft survival and clinical outcomes of the first case series after Descemet membrane endothelial keratoplasty (DMEK). DESIGN: Retrospective, interventional case series. METHODS: After excluding the very first 25 DMEK eyes that constitute the technique learning curve, the following 100 consecutive primary DMEK eyes (88 patients) were included. Main outcome parameters (survival, best-corrected visual acuity (BCVA), central endothelial cell density (ECD), central corneal thickness (CCT)) were evaluated up to 10-years postoperatively and postoperative complications were documented. RESULTS: At 5 and 10 years after DMEK, respectively 68 and 57 out of 100 eyes were still available for analysis. Of those eyes, 82% and 89% reached a BCVA of ≥20/25 (Decimal VA ≥0.8) at 5- and 10 years postoperatively, respectively. Preoperative donor ECD decreased by 59% at 5 years and 68% at 10 years postoperatively. CCT averaged 668 (±74) μm preoperatively, and 540 (±33) μm and 553 (±43) μm at respectively 5 and 10 years after surgery. Within 10 years, 4% of eyes developed allograft rejection, no primary graft failures occurred and 6% of the eyes developed secondary graft failure. Graft survival probability was 0.83 [95% Confidence Interval (CI), 0.75-0.92] and 0.79 [95% CI, 0.70 -0.88] at 5- and 10-years postoperatively, respectively. CONCLUSION: Most eyes operated in the pioneering phase of DMEK show excellent and stable clinical outcomes with low postoperative complication rates and promising graft longevity over the first decade after surgery. This suggests that DMEK may be a safe long-term treatment option for corneal endothelial diseases.
Authors: Friso G Heslinga; Ruben T Lucassen; Myrthe A van den Berg; Luuk van der Hoek; Josien P W Pluim; Javier Cabrerizo; Mark Alberti; Mitko Veta Journal: Sci Rep Date: 2021-07-07 Impact factor: 4.379
Authors: Gerd U Auffarth; Hyeck-Soo Son; Matthias Koch; Jan Weindler; Patrick Merz; Ofer Daphna; Arie L Marcovich; Victor A Augustin Journal: Cornea Date: 2021-12-01 Impact factor: 2.651